title: Spiritual care of the child with cancer at the end of life: a concept analysis.
abstract: OBJECTIVE
  The aim of this paper is to report an analysis of the concept of spiritual care of a child with cancer at the end of life.
  
  
  BACKGROUND
  Spirituality is a vital dimension of a child's experience at the end of life; providing comfort; support; and a sense of connection. Spiritual care is paramount to address the substantial spiritual distress that may develop.
  
  
  METHODS
  Rodgers' method of evolutionary concept analysis guided the review process.
  
  
  METHODS
  The literature search was not limited by start date and literature through the end of 2012 was included. English, peer-reviewed texts in the databases CINAHL, ATLA and PubMed were included.
  
  
  METHODS
  Critical analysis of the literature identified surrogate terms, related concepts, attributes, antecedents and consequences.
  
  
  RESULTS
  The analysis identified six attributes: assessing spiritual needs; assisting the child to express feelings; guiding the child in strengthening relationships; helping the child to be remembered; assisting the child to find meaning; and aiding the child to find hope. Antecedents include existential questions and spiritual distress. Consequences include a peaceful death, spiritual growth, a relationship of trust and enhanced end-of-life care.
  
  
  CONCLUSIONS
  Spiritual care is a vital aspect of holistic nursing care; however, gaps in knowledge and practice prevent children from receiving adequate spiritual care at the end of life. Nurses would benefit from increased awareness, skills and knowledge about spiritual care. Research is needed to identify interventions that exert the greatest effect on patient care outcomes.
authors.affiliation: Marquette University College of Nursing, Milwaukee, Wisconsin, USA.
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Petersen
mesh_terms: D000293:Adolescent; D001291:Attitude of Health Personnel; D001293:Attitude to Death; D002648:Child; D005260:Female; D018939:Holistic Nursing / Q000379:methods; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000401:mortality / Q000451:nursing* / Q000523:psychology*; D009723:Nurse-Patient Relations; D009741:Nursing Staff, Hospital / Q000523:psychology*; D010371:Pediatric Nursing / Q000379:methods*; D026443:Spiritual Therapies / Q000706:statistics & numerical data; D029181:Spirituality; D013727:Terminal Care / Q000523:psychology*
keywords: cancer; child; concept analysis; dying; nurses/midwives/nursing; spiritual care